Trans Rights and Healthcare are on a Precipice

This piece comes from an anonymous contributor, a comrade of the writers of Feminist Ire, speaking out at a crisis point in trans healthcare in Ireland from the perspective of a trans woman. 

I’m currently writing with feelings of anger, sadness and frustration at two powerful elements within Irish society that seem intent on further damaging the health and well being as well as perpetuating the overwhelming stigmatisation of trans people in this country. When we peel back the surface and uncover the plight of Trans people this ultimately and all too often reveals itself in violence, disenfranchisement, poverty, rape, self harm and suicide. It’s often highlighted in discussion around trans topics, the terrible statistics of self harm and suicide when it comes to the trans community for example. To reference some headline figures a study by the Transgender Equality Network of Ireland in 2012 shows that 78% of trans people have had thoughts of suicide, 40% have attempted and 6% have attempted five or more times! Self harm is not much better with 44% of trans people reporting that they have self harmed at some stage in their lives with 6% actively currently self harming. Unfortunately this very plight of trans people which should be an impetus to drastically improve the standards of care for a vulnerable and suffering minority is often used as a stick to beat us with.

These heartbreaking statistics are a reflection of a wider societal issue, that of the systematic oppression of trans minorities where a binarist, cisnormative, patriarchal society violently attacks in both it’s messaging, actions and structures, every aspect of trans people’s public and private lives as we fight to exist openly and authentically and navigate within it. The statistics quoted above are a snapshot taken three years before marriage equality and legal gender recognition had passed and at an earlier stage in a sizemic cultural shift currently taking place on this island, which has seen a new generation of progressive and radicalised citizens and residents pushing through sweeping social reforms and resisting privatisation through grassroots activism in a country still dogged by it’s colonial and theocratic past. Indeed this aspect of Irish culture and the potential it envokes in shaping our society in the near future makes this Island a pretty good place to be trans comparatively, albeit coming from a very low base. The presence of a strong grassroots, intersectional and women led network of activists has helped to stave off much or the recindance of trans rights that can be seen happening within our two giant anglophile neighbours. To our left we have bathroom ‘debates’ and the dismantling of legal protections along with scores of murdered trans people, excused through panic defense. To our right we have the potential of a depathologised legal recognition for trans and intersex people being attacked, alongside numerous cases of trans women sent to their deaths in male prisons.

However despite this somewhat favourable environment, there remains two large and prescient threats to the progress of trans liberation in Ireland. Namely, a couple of chiefs based within one hospital in south Dublin who seem intent on limiting access to health-care and perpetuating an outmoded and dangerous conservative pathological ideology, discouraging people from transitioning where possible, refusing to listen to the increasingly angry and desperate voices of the trans community, refusing to implement international best practice when it comes to trans health care, criticizing us for demanding such health-care and proportioning partial blame on the healthcare demands of the trans community for the regrets of a small number of detransitioners all the while conflating their situation with the desperate mental health situation alluded to above. Thier prejucicial elitist practices are resultingly working to conserve the violent patriarchal transmysogonist aspects of a society that kills us and in order to do this these dinosaurs are allying themselves with traditional media to spread this destructive message and shore up their status as Ireland’s premier gatekeepers. This is a high risk strategy and very dangerous to the health and wellbeing of trans people, the same people they proport to care for.

The media narrative in Ireland in relation to trans people is currently being pulled in two destructive and harmful directions. On the one side there is an old school and elitist club, most prominent within the broadcast and ‘newspaper of record’ realms that projects a veneer of liberalism, but in reality paints over the cracks of a declining conservative, ignorant and voyeuristic mindset influenced by the ‘medical oddity’ genre of pseudo scientific transexual documentaries of the 90s to early 00s emanating from either side of the pond. The impact of this club’s influence can partially be evidenced in the cautious language reflected in the recent together for yes campaign which amongst other things erased the effect that the eighth ammendment had on trans and intersex people in much of its messaging in the penultimate weeks of the official referrendum campaign.

While many trans people who worked hard to secure a yes outcome and their grassroots allies were prepared to begrudgingly go along with this messaging to secure a victory by not actively speaking out, a hurt and resentment remains that has spilled out in potentially destructive ways. A statement from anonymous members of the trans community demanded an apology from together for yes literally hours after the results were declared. This resulted in an unintentional indirect attack on the grassroots, who are made up of pragmatic trans people and their allies and threw trans women and femmes to the TERFs. The downplaying of the intersection of trans and intersex people in relation to the 8th has also resulted in gendered language in the headings of the prospective legislation which, if not rectified could potentially leave trans and intersex people with uteruses still unable to access abortion healthcare in Ireland. Thankfully there seems a concensus around rectifying this situation but this should never have arisen in the first place.

On the other side there is a red top brigade that on the one hand is perfectly content to sensationalize, hypersexualize and dehumanise the trans experience to titillate and incense their diminishing white cis-hetero audience. They are in turn being pushed into even more dangerous territory by their sister publications in the UK that are largely owned by an increasingly centralised right wing conservative and billionaire class, who by co-opting the language of feminism and fueled by evangelicals are giving voice to their willing lackeys in the form of a loud minority of middle class TERFs who are ramping up their attacks on trans people. This tactic compliments their agenda of dividing people into competing groups and hierarchies to distract from intensifying inequality, debt and economic stagnation caused by their economic plunder. Although making inroads into online spaces where increasingly their once captive audiences have deserted to, their impact on these realms on the mindset of people living in Ireland remains limited. That being said it’s this cohort of nasties that have the potential to derail impending legislation that should increase the ease of legal transition for trans people in Ireland and regognise non binary and intersex identites. Hopefully the former cloak offered by the marriage equality results and resulting legislation while the original gender recognition bill was passed will again be offered by the success of the repeal campaign.

The results of this unholy alliance between the chiefs and the dieing media, aside from the problems stated above is that healthcare in Ireland for trans people is in a dangerous and delicate impass. The chiefs want to model the recent and welcome investment in trans healthcare in their own image, to preserve the status quo and bolster their own professions albeit with shorter waiting times. Trans people as individuals are a small disparate and oppressed minority with limited voice, resources and energy fighting for a depathologised and informed consent model that is on demand and without apology. We are at the mercy of the chiefs despite a favourable cultural environment, despite support from politicians, and even tacid support from the health service.

What we’ve currently been able to muster in terms of advocating for health care is a small and problematic campaigning group centered around inexperienced trans-masc indivituals who are currently on the outside of the health system. They speak out loudly and attempt mass protests for healthcare. They have uncovered the sinister ideology begind the masks of the chiefs but they tone police their own community members who wish to speak out at protests, disengage with non-binary ‘trouble makers’ online and sit in meetings with the likes of Joan Burton and celebrate it. Of special note however is the emergence of Radical Queers Resist, a broader queer alliance who came to light during the refferendum campaign by largely nullifying the effects of the most grotesque forced-birther group in the form of the ICBR. This group offers the potential of offering an effective avenue for the campaigning elements of the trans liberation movement going forward.

Meanwhile non profit organisations working largely within the system with limited clout, work desperately behind the scenes despite stretched resources and limited funding pools. They are, as the system dictates heavily funded by the very organisations they are advocating towards. They can not speak out for fear that the chiefs in a strop, stop treating half of the countrys trans patients within the health system overnight. The only solution is the mobilisation of the existing wider grassroots movement of allies. This has the potential to effect change in our favour but it must be built upon a greater understanding of our predicament and the sharing of experience and resources. This can be realised through the amplification of our voices through the correct use of it’s inherant privelege.

In the meantime waiting lists continue to lenghten causing massive mental strife. Trans people continue to be subjected to invasive and unnecessary psychological and psychiatric assessment based on outmoded and offensive criteria, being actively discouraged in their hormonal and medical transitions and twarted at every stage. Non-binary people have to lie and pretend not to exist in order to access the same treatment as their binary counterparts, access to counselling and non-patholigising forms of mental health care is sparse to non existant albeit linked with the wider defunding of mental health. Recieving hormone replacement therapy for already transitioned individuals from GPs on a parity with their cisgender counterperts is almost impossible. Autistic people and those with other and often linked mental health problems such as PTSD are not deemed to be ‘true transgender’, expensive treatments deemed cosmetic because they don’t conform to the male gaze of medical practitioners rather than seen as alleviating the distress of dysphoria remain out of reach and patients are forced to travel abroad for intensive operations with limited aftercare and financial support. The potential outcomes of this impasse will have a greater threat to the lives of trans people than the unfortunate decisions and regrets of a minority of detransitioners currently being used as false equivalencies to preserve the status of the chiefs.